Early single‐channel aEEG/EEG predicts outcome in very preterm infants

Abstract

Aim: To characterize early amplitude‐integrated electroencephalogram (aEEG) and single‐channel EEG (aEEG/EEG) in very preterm (VPT) infants for prediction of long‐term outcome. Patients: Forty‐nine infants with median (range) gestational age of 25 (22–30) weeks. Methods: Amplitude‐integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 0–12, 12–24, 24–48 and 48–72 h, for background pattern, sleep–wake cycling, seizures, interburst intervals (IBI) and interburst percentage (IB%). In total, 2614 h of single‐channel EEG examined for seizures. Survivors were assessed at 2 years corrected age with a neurological examination and Bayley Scales of Infant Development‐II. Poor outcome was defined as death or survival with neurodevelopmental impairment. Good outcome was defined as survival without impairment. Results: Thirty infants had good outcome. Poor outcome (n = 19) was associated with depressed aEEG/EEG already during the first 12 h (p = 0.023), and with prolonged IBI and higher IB% at 24 h. Seizures were present in 43% of the infants and associated with intraventricular haemorrhages but not with outcome. Best predictors of poor outcome were burst‐suppression pattern [76% correctly predicted; positive predictive value (PPV) 63%, negative predictive value (NPV) 91%], IBI > 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% > 55% at 24 h age (79% correctly predicted; PPV 72%, NPV 80%). In 35 infants with normal cerebral ultrasound during the first 3 days, outcome was correctly predicted in 82% by IB% (PPV 82%, NPV 83%). Conclusion: Long‐term outcome can be predicted by aEEG/EEG with 75–80% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.

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Cited by papers we hold 3

• Current Status and Future Directions of Neuromonitoring With Emerging Technologies in Neonatal Care · 2022
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• Preterm Hypoxic–Ischemic Encephalopathy · 2016
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• Early Diagnosis and Early Intervention in Cerebral Palsy · 2014
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